Medication Review in Preventing Older Adults' Fall-Related Injury: a Systematic Review & Meta-Analysis.

Abstract

BackgroundMedication review is essential in managing adverse drug reactions and improving drug safety in older adults. This systematic review evaluated medication review’s role as a single intervention or combined with other interventions in preventing fall-related injuries in older adults.MethodsElectronic databases search was conducted in PubMed, EMBASE, Scopus, and CINAHL. Two reviewers screened titles and abstracts, reviewed full texts, and performed data extraction and risk of bias assessment. Meta-analyses were conducted on studies with similar participants, interventions, outcomes or settings.ResultsFourteen randomized, controlled studies were included. The pooled results indicated that medication review as a stand-alone intervention was effective in preventing fall-related injuries in community-dwelling older adults (Risk Difference [RD] = −0.06, 95% CI: [−0.11, −0.00], I2 = 61%, p = .04). Medication review also had a positive impact on decreasing the risk of fall-related fractures (RD = −0.02, 95% CI: [−0.04, −0.01], I2 = 0%, p = .01).DiscussionThis systematic review and meta-analysis has demonstrated that medication review is effective in preventing fall-related injuries in general, and fractures specifically, in community-dwelling older adults. Future investigations focusing on the process of performing medication review will further inform fall-related injury prevention for older adults.